狂犬病人免疫球蛋白与狂犬疫苗联合应用后发生狂犬病死亡原因分析  

Analysis on death causes of rabies after combined application of immune globulin and rabies vaccine

作　　者：王丽环[1] 李铁华[1] 陈贵智[1] 

机构地区：[1]内蒙古疾病预防控制中心,呼和浩特010031

出　　处：《医学动物防制》2013年第9期968-970,共3页Journal of Medical Pest Control

摘　　要：目的探讨疯犬咬伤人后不同的伤口处置方法及注射狂犬病人免疫球蛋白和狂犬疫苗与发生狂犬病死亡的关系。方法用描述性流行病学方法对发生狂犬病的病例进行原因分析。结果 5例被疯犬咬伤的患者,注射狂犬免疫球蛋白并全程注射狂犬疫苗,其中2例采取的是一般消毒措施,并在3d后注射狂犬免疫球蛋白,分别于14d及40d发病死亡;另3例咬伤后立即采取反复冲洗,用20%肥皂水冲洗、2%~3%碘酒消毒,并在伤口周围进行狂犬免疫球蛋白侵润注射,截止发稿之日3例伤者均未发病。结论联合使用被动免疫制剂及狂犬疫苗对预防狂犬病并非是绝对安全,一定要及时有效地处置伤口。及时注射狂犬免疫球蛋白并在伤口周围侵润注射狂犬免疫球蛋白是必要的。Objective To discuss the relationship of different wounds disposal methods and injection of rabies immunoglobulin with death.Methods The rabies cases were analyzed by the descriptive epidemiology method.Results There were five patients injected with rabies immunoglobulin and rabies vaccine.Two of them only took general disinfection measures and were injected with immune globulin three days ago,it led to paroxysm and death after 14 days and 40 days.The other three patients washed again and again firstly,then washed by 20% suds and disinfected by 2% ~ 3% iodine,lastly they were injected with immune globulin around the wounds.The three patients were alive now.Conclusions It is never absolute safe by combined application of immune globulin and rabies vaccine.The best way is treating the wound in time.It is necessary to inject the rabies immunoglobulin and infiltrate rabies immunoglobulin around the wounds.

关 键 词：狂犬病 狂犬病人免疫球蛋白 狂犬疫苗 处置伤口 

分 类 号：R512[医药卫生—内科学]